During a period of time when the computerized medication order system was down, the prescriber wrote admission the nurse is transcribing them. The nurse is having difficulty transcribing one order because of the prescriber's handwriting. Which is the best action for the nurse to take at this time?
Ask the client what prescribed medications are taken at home
Contact the prescriber to clarify the order.
Wait until the prescriber makes rounds again to clarify the order
Ask a colleague what the order says.
The Correct Answer is B
A) Ask the client what prescribed medications are taken at home: While obtaining information about the client's home medications is important, this action does not address the specific issue of the unclear order. It is not an appropriate substitute for clarifying the medication order that the nurse is having difficulty transcribing.
B) Contact the prescriber to clarify the order: This is the best action for the nurse to take. If the nurse is unsure about the order due to illegible handwriting, the safest and most effective way to clarify the order is to directly contact the prescriber. This ensures that the nurse administers the correct medication and dose, reducing the risk of medication errors.
C) Wait until the prescriber makes rounds again to clarify the order: Waiting for the prescriber to make rounds is not an appropriate or timely solution. Medication administration should not be delayed due to unclear orders, as it could lead to treatment delays or potential harm to the patient. Immediate clarification is necessary.
D) Ask a colleague what the order says: While consulting a colleague might be helpful, it is not the most reliable or safe course of action. The nurse should not rely on others to interpret unclear orders, as there may be different interpretations or misunderstandings. Contacting the prescriber directly ensures the order is clarified accurately and safely.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) Peptic ulcer: Scopolamine is an anticholinergic medication that works by blocking acetylcholine, which can reduce nausea and motion sickness. While scopolamine can have anticholinergic effects that may slightly reduce gastric motility, it is not directly contraindicated in clients with a history of peptic ulcer. The medication does not significantly exacerbate the condition of peptic ulcers.
B) Asthma: While scopolamine can have anticholinergic effects that may lead to dry mouth and slight airway narrowing, it is not contraindicated in clients with asthma. However, the nurse should be cautious and monitor the client for any signs of respiratory distress, as anticholinergic medications can cause some bronchial smooth muscle relaxation, which could theoretically worsen asthma symptoms. It is not an absolute contraindication.
C) Heart disease: Scopolamine is not specifically contraindicated for individuals with heart disease, although caution should be used in patients with cardiovascular conditions due to its potential effects on heart rate and blood pressure. However, heart disease itself is not a direct contraindication for the use of scopolamine.
D) Glaucoma: Scopolamine is an anticholinergic medication, and anticholinergics can increase intraocular pressure. This is especially dangerous for clients with narrow-angle glaucoma, as the medication can exacerbate the condition, leading to a potential acute glaucoma attack. Therefore, individuals with a history of glaucoma, particularly narrow-angle glaucoma, should avoid scopolamine.
Correct Answer is C
Explanation
A) The stomach acid has a lower pH level which results in increased absorption: While it is true that neonates have a lower gastric pH, which could affect the absorption of certain medications, this factor does not directly increase the risk for drug toxicity. Lower pH may increase absorption for some drugs, but it is not as critical in neonates as the immaturity of other organs, such as the liver and kidneys, which are responsible for drug metabolism and excretion.
B) The glomerular filtration rate (GFR) is increased causing rapid excretion: In neonates, the glomerular filtration rate (GFR) is actually decreased, not increased. This leads to slower excretion of medications, which can increase the risk for drug toxicity, especially for drugs that rely on renal elimination. This decreased renal function can result in accumulation of the drug in the bloodstream, potentially leading to toxicity.
C) The liver enzyme system responsible for drug metabolism is not fully developed: The liver enzyme system in neonates is immature, which significantly impacts the metabolism of drugs. Enzymatic activity is critical for breaking down medications to their active or inactive forms. Due to the underdeveloped liver function, drugs may not be metabolized properly, leading to a longer half-life and an increased risk for drug toxicity. This is a key factor in the increased risk of toxicity in neonatal clients.
D) The albumin levels are elevated due to rapid growth and protein binding is enhanced: Neonates typically have lower albumin levels, not elevated levels. Albumin is crucial for binding medications, and lower levels in neonates can result in more free (unbound) drug circulating in the bloodstream, which can increase the risk of drug toxicity. Elevated albumin would theoretically reduce this risk, but this is not typically the case in neonates.
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